3/15/2016

BASIC HARA DIAGNOSIS

An Introduction to Kiiko Style
The “Avi Way”
Full classes with treatments are available on
http://acupuncturemedical.org/teaching-videos

www.acupuncturemedical.org/teaching-videos

This Style vs TCM Treat the Underlying Weakness

Terminology – use Western rather than

Chinese terms A TCM Pattern is a Description, it is not a
Extensive use of Medical History cause
Reliance on Palpation as a form of What is holding the patient from healing?
diagnosis Clear the past so as to heal the present
Testing – obtaining immediate feedback

Principles/Process of this Style

Gather Medical History
? Why do you have this?
? What predisposed you to it? Gather Palpatory Findings
? Is it your mother’s thyroid? Correlate & Prioritize
? Is it papa’s heart condition?
? Is it medications that affected the Liver? Test and Treat
? Is it high sugar consumption?
Keep going between steps 3 and 4 (prioritizing/diagnosing
and testing) until you find the point combination that
? What is the ROOT that is clears the abdomen most effectively.
If you are unable to get an effective treatment from your
holding you back? diagnosis, go back to steps 1 & 2 (change diagnosis!)

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Medical History Palpatory Findings

Get the General Picture first
Chronological order Do not try and resolve anything until you
including birth and inherited diseases have the full picture so you can prioritize
Look for the “first injury” Palpate the abdomen, neck & throat
Look for most significant injuries/events it is hard to palpate and test the back
Can you identify the “root”? when the patient lies face up
Root = the injury that when addresses
knocks of all other findings like a
Channel Palpation
domino effect Fire point diagnosis, bumps, edema, etc.

Prioritizing Testing
Is the first injury reflecting in the body? Does this strategy (Step 3) resolve the
abdomen? How fully?
Most significant aspects of medical history
Look for the “one strategy” that clears the
Most signficant palpatory findings whole abdomen, neck and back
Here we correlate all that we have found and This is not always possible
create a “strategy“,” a “story” that explains why 2-3 strategies are sometimes needed
the patient has this condition.
This strategy may be wrong, hence we test it. A strategy/protocol that clears only one finding is less
Keep going through strategies, abandoning what valuable than one that clears many.
does not work, until you find the best stategy. Abandon less efficient startegies!

Medical history – Left SP13-14

contaminated rabies shot
Baseline
Findings –
Patient needs to know what
tiny scar on left ST26
your hand feels like.
Treat as if rheumatoid
Success! Except if colon issues
Root is chemical (colon patients may have
contamination predisposing pressure pain here)
him to arthritis.

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Right ST26-27
Left ST26-27
May extend to under Reflects –
left Kid16 Immune
Lung
Reflects – Oketsu Digestion
Pelvic shift
Treat – Kidneys
Left Liv4 + left LU5
May reflect any of those
(one or more)

4 & 8 O’clock Ren9

(below Kid16)
Pressure Pain – sadness
Pulse – Weak Dan Tian
Reflects – You may feel the pulse above
Adrenal And also below navel on left side

Treat – Treat –
Kid6 + 27 for Sadness – SP3 + Per
may use: + Right ST24
Kid7
Kid7 + 10 for pulse – MuShu
Kid4 then Right ST24
Kid9 + Left G.B.26

Ren12
Beam across ST21
Reflects –
Weak Stomach, Reflects –
Weak start of meridians Panceatitic Tummy
Weak rugae (weak pancreas)
Neurological (Marrow)
Stress Treat –
Kid6, Kid27
Treat – SP5, LU5
Kidney
Stomach Qi
Immune
release neck (ANS)

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Ren15 Right Subcostals

Liv14
Reflects –
Worry Reflects –
digestion Liver
Cardiac (if up and to left) Sharp = Excess
Dull = Deficiency
Treat –
SP3 + Pericardium Treat –
Sharp: Right Kid7, SP7, HT3, P.4
Dull: Liv1
Fatty Liver: Right ST25, Liv13

Ren17
Gynecological
Reflects – Refexes
Anxiety
Insomnia Kid13 - Uterus
Cardiac Treat Liver/Spleen
Esophagus (hard pressure)
ST28 - Ovaries
Treat – Treat Kidney
Clear neck lymph:
Immune + S.J.8 male ureogenital reflexes will
(G.B.20 + S.J.16) tend to reflect lower - Ren3
Then – SP3 + Pericardium Kid11/ST30 for

SCM

Immune
L.I.10 L.I.11

Scalenes

TMJ

Immune Point
Angle towards S.I.

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SCM

Immune

Scalenes

TMJ

S.J.8
One third below the elbow
Needle towards S.I. channel

SCM

Immune

Scalenes Treatment points:

Scalenes
SP3
HT3
LU8
Inner Yin
TMJ

Inner Yin
5 fingers above Kid10 (level with Liv9)
Needle towards ST/G.B. channels

SCM ANS hormonal

Blood Pressure
Immune
The back of the neck
Cervicals 3-5 C1/Mastoid
can be palpated with
Scalenes the patient face up Immune

Reach your hand under

the neck and palpate
TMJ
on each side. Oketsu
(right only)
For opposite side
Cervicals – extend the
hand past the spine
then poke towards
spine

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ANS hormonal
ANS hormonal
Releasing the Occiput Blood Pressure Treating Cervicals Blood Pressure

Cervicals 3-5 C1/Mastoid Cervicals 3-5 C1/Mastoid

ANS – As a group –
use Under-3rd-Toe Immune S.J.8 (same side) Immune
(opposite side)
C3 – Liv1 for right side
SP1 for left side
Hormonal –
use U.B.66 C4 – ST9
Oketsu Oketsu
(same side) (right only) (right only)
C5 – L.I.18
Oketsu – C6-7 – HT3
Left Liv4 & LU5
Mastoid – Yao Tong Xue
+ Left St26/27
Liv13

On the Back
The Upper Back
Concentrate on Hua Tuo/Du (T1 – T7)
- clear the nervous system
T2 – Thymus
Less about clearing reflexes
- use reflexes as treatment Cardiac

Major curve changes: T4 - Eyes

Lungs
- T11/12 and T5
affect the whole back T1-T3 – Face &
ANS Brain
Clear back findings with: Asthma
- Sacro-iliac Insomnia T2-T9 - Shen
- DU2
- 4-Corners

The Mid Back The Lumbar Back

T7 – T12 L1 – Inguinal ligament
Right T7-T9 – Liver
Hua Tuo & U.B.18
L2 – Kidneys, Ears

Right T7-T9 – Liver Right T10 – G.B

Hua Tuo & U.B.18 + Right T2 & S.I.11 L3 – hips
Quadratus Lumborum -
Kidneys
T11, T12 - Sugar L5 – hormonal, Legs

Yao Yan - Legs

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The Sacrum
Actual S.I. Joint Area to Release Use
But Sacro-iliac S.I. joint G.B.34
ligaments can
be needled
more easily here Piriformis Huakaya G.B.31
Kid16
And can also be
extended to
under the iliac Tailbone LU8
crest
U.B.66
Tailbone T1 Hua Tuo
Check below & sides

Palpation in Order:
SCM
• Left ST26-27 – Oketsu Immune
• Right ST26-27 – lung, immune,
digestion, kidney,
pelvic shift Now the neck:
• 4 o’clock 8 o’clock – Adrenal
Scalenes
• Ren9 - Pulse = Weak Dan Tian • The SCM –
pressure pain = Sadness with the flat
• Ren12 – weak stomach
• ST21, Ren12 – Ulcers (ST21) part of the
Weak Pancreas (beam) fingers
• Ren15 – Worry • The Scalenes
up and left – cardiac
• Ren17 – Anxiety, Cardiac tip of fingers
TMJ
• Right Liv14 & Subcostal – Liver light pressure
• Kid13, ST28 – uterus and ovaries • S.J.16 - Immune
• Inguinal – weak ligaments
viscero-ptosis
blood flow blockage
• G.B.26 – twisting syndrome

ANS hormonal
Blood Pressure
The back of the neck
Cervicals 3-5 C1/Mastoid
Patient is still face up
Immune
What is the Root?
• Cervicals – both
sides
What is the Patient’s Type?
• Occiput – Oketsu
• Blood Pressure (right only)
• Hormonal –
more lateral
• Oketsu – right only

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Major Types used by Systems: Cardiac Reflexes

Endocrine System Nervous System
Circulatory System Ren15 pressed in and up
Immune System
Adrenal Tight Pulse type Ren17
Thyroid Cardiac
Vagus Congestion
Blood pressure
Nasopharynx Left Kid24-26
Sugar Blood Pressure Allergy
Anemia Left P.1
Estrogen Anxiety, Auto-immune
Pituitary Stomach Qi Left ST18
depression, panic

Left SP20
Structural Types: Metabolic Types: Other Types:
Skin & toxicity, respiratory,
Scoliosis, tail bone, head IBS, Constipation, etc Left S.I.11
weak marrow, weak Dan
injury, Viscero, TMJ, etc Liver metabolism Tian, Inflammatory, etc. Left U.B.43, 44

Cardiac Treatments Cardiac Treatments

Check pulse first: Rapid or slow, weak or strong Rapid or slow pulse?
Ren4 for rapid pulse
Treat weak pulse or edema first, U.B.27 for slow pulse
then you can treat the heart. regular pulse – use both/either

Weak/short pulse (no Chi position) Rapid pulse – use Under-2nd-Toe

First treat
SP6, SP9, Per - to build the blood Check U.B.60 (especially left)
Edema – pain on U.B.60 – use U.B.66, 67
Move the water before pushing the pump (heart) no pain – needle U.B.60 (upwards)
Use SP3, SP7, 11

Cardiac Treatments Pulse considerations

Now treat the “dried apricot” (puffy Slow pulse – do not needle lower abdomen
S.I.11) and the “dried papaya” (ropy Rapid pulse – exercise caution on spine
inner border of the scapula) – left
side. Weak pulse – use SP3, avoid SP4
Strong pulse – use SP4, avoid SP3
Surround left S.I.11 + Okyu
Irregular pulse – Use G.B.39, G.B.5
Inner border of scapula + Okyu Xuan (懸) Hanging
Heart (心) that is suspended (縣)

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Lung Reflexes Treating Lungs

Kidney line bilaterally – bronchial reflex LU5 and/or LU8
LU1-2 area
Right ST 26-27 Inhalation – use Kid4 (Da Zhong - 大鐘)
Exhalation – use SP4 (Chong)
Rhomboids (U.B.13 area)
S.I.9/10 – up and out
Yao Yan (lumbar Eye) – down and out

Trochanter – in front of trochanter:

creates space for chest to expand
clears U.B.13

Spleen Types
Treating Lungs
SP9 Type:
U.B.13/U/B.42 is the target * Appendix (left ST26-27)
* Bloated abdomen
Reduce puffy and pressure pain first:
(full palm pressure on inguinal)
Trochanter, S.I.9/10, Tao Yan
* G.B.21 (exact spot) pain
then needle and Okyu U.B.13/42
SP3 Type:
U.B.17 is Asthma and Diaphragm Shu * Scalenes
Kawai’s Lung Combination: * Muscular pain type
Ding Chua, U.B13, * Sugar type
U.B.17, U.B.20 T11,12 on the back
all with Kyutoshin (or use Okyu) “Pear shape” –
thick thighs, skinny waist and above

Other Spleen Types Liver reflexes

SP7 – for edema, bleeding, ear infections Right subcostal and/or Liv14
find the hole behind the bone
Right U.B.17-18 or Hua Tuo
SP6 – for the anemia patient
for blood pressure problems “Apple shape” -
for vertex headaches skinny legs and round abdomen

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Liv1 (2)

Liver Excess Liver Deficient Type

Physical Liver Damage: Liv1 (+ okyu moxa) Liv1 (1)

Right Kid7, SP7, HT3, P.4 choose the best Liv1

Liv1 (3)

Liv2 pressure pain: Liv1 (4)

(Typical in alcohol issues)
Liv4 + Liv8

Mouth Sore type:

Liv3 + SP3 bilateral
Liv1 (alternative)

Fatty Liver Type Toxic Liver Type

Kid9 + L.I.15 (add okyu to L.I.15)
Obese patient – use full treatment
Left G.B.26, Left ST27,
Ren6, Undefined/Mixed Liver Type
Right ST25, Right Liv13 Kid9
G.B.28
Non-Obese – use abbreviated treatment Right of DU20 (between U.B. and G.B.)
Right ST25 + Right Liv13
Liver Back Treatment:
Left U.B.35
may also needle U.B17/18 area or T7/T9 Hua Tuo

Kidney/Adrenal reflexes Adrenal Treatment

4 o’clock and 8 o’clock Kid6 + Kid27
Kid2 pain
Valley back Substitute Kid6 with
Quadratus Lumborum pain Kid7 + 10 – if Kid2 is painful
Kid4 – for lung with inhalation problems
Physical Kidney –
Kid9 – for TMJ, neck, goiter or emotional issues
may reflect on SP15
Kid3 (nodule above) – for brain injury type
Kidney stones –
pain on tapping on G.B.26
Tight G.B.26 –
salt eating type, or structural twist

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IMMUNE TYPE ANS (Autonomic Nervous System) TYPE

Weak immunity, There are no clear reflexes for the autonomic nervous system
lymph congestion, However it may show on the following:
tonislectomy, nasal allergies,
pain across posterior iliac crest, Tight SCM, (pressing on the Vagus nerve)
temporal headaches Occipital tightness or pressure pain
(this is An Mian, 安眠, Peaceful Sleep area)
Reflexes:
Tight diaphragm (also C3)
S.J.16, R ST26/27
Liv12
Treatment: Ren17
Immune Point Ren9
Du14 T2-T9, especially T5 and T7
Du12 Left inner border of scapula (U.B.43, 44)
Under Scapular Spine

NERVOUS SYSTEM SYMPTOMS NERVOUS SYSTEM PULSE

Insomnia
Palpitations Tight Pulse by Nagano is
sweat easily (hands and feet) the quality is tight (TCM’s “thin wiry”)
cold hands and feet disappears upon pressure
easily startled it changes quality and becomes wider/hollow
anxiety, depression or panic
unusual blood pressure, often low Distinguish rapid and slow pulses

In parasympathetic mode –
increased peristalsis, increased urination,
heart burn

NERVOUS SYSTEM TYPE TREATMENTS

Under-3rd-Toe – if pulse is not slow, or it is clearly tight Immune
S.J.8 for regular and slow pulse, S.J.5 for rapid pulse
Pericardium (check P.8)

Ren6 (rapid pulse only)

Liv12 (rapid pulse)

DU2
Nervous
S.I.9/10 Adrenal
System
T5, T7

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BLOOD PRESSURE DISORDER TYPE Ren9 PULSE TYPE

This include high, low as well as “weird” gap This indicates a weak Dan Tian, or weak mesentery tissue
Normal gap between systolic and diastolic is 40mmHg
Findings:
There is no one clear reflex for blood pressure issues Ren9 pulse
(may extend above, may extend below on the left)
Treatment: Left SP20
SP6, SP9 + Pericardium
Treatment:
(check P.8 and determine accordingly)
By Kiiko – Right ST24 (direct needle slightly outwards)
Under 3rd-Toe (check pulse is not slow)
Left G.B.26
U.B.17
By Avi - Mu Shu (may add U.B.2)
S.I.9/10
then Right ST24 + Left G.B.26 if necessary
U.B.52 – needle towards DU4

THYROID TYPE SUGAR TYPE

Reflects on ST9, and middle and lower parts of the SCM Sugar imbalance – SP3 + T11/12
Treat with Kidney points Diabetes - SP3
originally – Kid3 for hypo, Kid7 for hyper, Kid9 for goiter Adrenal (Kid below knee + 27)
however, do not rely on this and check the effect on ST9 Immune
ST Qi – can be useful also (ST9 is thyroid reflex) Odi (right ST22)
T11,12
Hypothyroid – activate the Du
Du2, (L2), T11,12, T7, T5 (or T9, T4) Use SP3 for muscular pain
Use Odi for muscular pain and bruise pain
Consider autoimmune issue
Consider toxicity (Kid9, L.I.15) Consider Diabetes to also be autoimmune (add Ren4 etc.)
Always treat Liver and Thyroid in any type of cancer Consider Fatty Liver treatment

LACK OF STOMACH QI AUTOIMMUNE TYPE

These are the bumps along the Stomach channel, There are no specific reflexes, but the mastoid may show
between ST40 and ST41 This is a primary type
Needle down and towards the bone
Treat systemic Metal/Water (Kidney and Lung) + S.I.Shu/Mu
• for “lack of Stomach Qi” in the pulse Rapid pulse:
– the pulse has no forward movement Ren4, Kidney + Lung
• for knees (or use SP5 + ST41) (check for best Kidney and Lung ponts)
• Bending-Stretching point (as are Sacro-iliac)
Slow pulse:
• seasonal changes (including allergies)
U.B.27, U.B.23 or 52 + U.B.13 or 42
• time adjustments
IHiKun (U.B.60, 58, 40 – anything that started with a fever)
Rapid pulse – consider S.I.1, 2, U.B.66, 67

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Hormonal Type Reflexes

HORMONAL TYPE
Reflects on –
U.B.2, Occiput, S.I.13
also Inner Yin area
U.B.2 Treatment:
Inner Yin
(By Avi) U.B.66 (足通谷 Zu Tong Gu)
Occiput Kid10 (or Kid7)
Inner Yin
S.I.13 U.B.2
S.I.13
U.B.32
Birth Control Pill – S.I.3

OTHER HORMONAL LACK OF INNER LEG & PERINEAL FLOOR AWARENESS

also known as the MuShu Type
Menopause/hot flushes:
Adrenal (Kid6 + 27, or Kid below knee + 27)
SP9, G.B.34
申 Shen – to extend
comes from 臼 – two hands extending a rope
Inguinal (G.B.27/28)

Cysts: 舉 Ju lift, raise, uphold, whole

Liv8 (add okyu) Kid6 Lift starts at feet, activation of Kid6,
Inner Yin Into the inner thigh
Mu Shu activating the Perineal Floor
up the spine to the throat
ST9
or U.B.2 coordinating the 3 Dan Tians

INGUINAL / INNER THIGH

VISCERO-PTOSIS TYPE
Pressure pain on Inguinal Inner Thigh release with:
Kid7
From –
Liv4
over-weight
SP9
large breasts
hysterectomy
Inguinal release with:
Immune
Treatment –
Liv4
ST13 up and out
G.B.26 Kidney Liver Spleen
Inner Yin
Immune

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BASILLARY ARTERY INSUFFICIENCY HEAD INJURY

Reflects on cervicals can reflect on SCM and cervicals,
can reflect opposite of injury
Symptoms – dizzy, vision, weak
legs, stroke Shao Yang injury -
U.B.40
S.J.8 (+G.B.40)
either
Treatment – rapid pulse S.J.5 + G.B.41 location
S.J.8, Liv8, Kid10 Tai Yang injury:
by Avi substitute– IHiKun
Liv8 or Inner Yin
Kid7 or Kid9
U.B.60 (Kun Lun)
U.B.58 (Fey Yang – Hi Yang)
IHiKun – U.B.60, 58, 40 U.B.40 (Wei Zong – I Zong)
Kid3, DU4

TAIL BONE INJURY NOSE INJURES

Pain on tailbone, Including broken nose or
below, or on sides deviated septum
Can affect whole spine and
Immune Points
nervous system
G.B.40
DU23
Treatment –
DU2
U.B.66
BiTong/L.I.20
LU8
(+ magnets or diode rings)
C7/T1 Hua Tuo

Deviated septum -
one nostril is narrower

METAL / WATER Treatments

TMJ
If the Fire point on any channel is Fire
Reflects on: painful on palpation
ST6 area
may show on mastoid use Metal and Water points on Wood Earth
that channel
May also have: Water
headaches overcome Fire
auditory problems Water Metal
dizzy Systemic inflammation:
use Metal/Water channels
Treatment: (Kidneys and Lungs) Metal nourishes Water
Kid9 + 27, S.J.8 Or check all Fire points. to overcome Fire
behind G.B.21

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ANTI-INFLAMMATORY POINTS DETOX & SKIN

Liv5 – anti-inflammatory for lower Jiao Anti-inflammatory ST41 Kid9 + L.I.15 – any skin or detox
Needle towards G.B.40 check against Thyroid and Liver
SP5 – anti-inflammatory point
Liv5 Okyu – for eczema,
ST41 – anti-inflammatory point
itchy or oozing skin,
for anti-inflammatory ST41,
poison oak
take it one tendon over from G.B.40
needle angle – towards G.B.40
U.B.63 – Metal Gate 金門 for boils and diarrhea
(cock’s crow type)
Regular ST41
Needle towards Kid6

BY PULSE POINTS TO CONSIDER AS TYPES

Liv5 – anti-inflammatory, endometriosis

Short/Weak No ST Qi No Spleen Flooding
Liv8 – cysts
SP6 + Per Stomach Qi SP3 Ren4/UB27
SP7 – water retention, bleeding

SP9 – appendix type

Wiry Tight
Kid9 – inguinal tension, TMJ, detox
G.B.39, SP9 3rd-Toe
Kid7 – bones, ovaries, Kid2 pain

POINTS TO CONSIDER AS TYPES II POINTS TO CONSIDER AS TYPES III

Stomach Qi – lack of Stomach Qi pulse Ren4 – autoimmune, cardiac

G.B.39 – wiry pulse, scoliosis Ren6 – rapid pulse

U.B.66 – hormonal Ren12 – neurological conditions, spine

Under-3rd-Toe – blood pressure & ANS DU2 – ANS, spine

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POINTS TO CONSIDER AS TYPES IV Decision Making Flow – start with the pulse

Immune – immune and lymph, nasal,

Ren12 pp, temporal HA
Pulse –
restricted circulation? Qi and Blood
S.J.8 – tight SCM, tight cervicals
S.J.5 – same as S.J.8 but for rapid pulse not moving!
important in pain • Low blood pressure?
• Weak pulse/anemia?
Treat these first
Pericardium – choose according to P.8 • Lack of Stomach Qi?
blood disorders (with Spleen)
Insomnia/emotional

Decision Making Flow – Flow Blockages? Decision Making Flow – Type Determination

Blocked Circulation
Body Signals Does abdomen show?
(blood, lymph, nerve)? are slow!
• Adrenals? Primary Types!
• Immune?
• Tight SCM? Release blockages to
• Congested Cervicals?
• ANS (SCM or by pulse)? Must be treated
enable circulation. • Ren9 Pulse? (or at least considered)
• Inguinal Tightness?
Enable brain/organ • Endocrine?
• Inner thigh tightness? sugar, thyroid, estrogen?
communication

Decision Making Flow – Systemic Diseases? Everything else

Metabolic or systemic Whole body is What is still Address those!

disorders? unresolved?
affected!
Choose points that
• Diabetes? • In abdomen/neck/back
• autoimmune? Address these • In history
best affect the
• cardiac? diseases first • In symptoms whole picture

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